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75 posts from February 2005

February 24, 2005

Art Linkletter and Richard Nixon

Hesiod just said the dardnest thing:

The Rove/Bush/Pharmaceutical industry front organization, and AARP gnat, USANext’s official “National Chairman,” is none other than Art Linkletter.

Most people know of Linkletter as the original host of that goofy TV show that made comedy hay out of the cute responses kids gave to Art’s “probing” questions. Or, maybe, as the spokesman for Craftmatic adjustable beds.

But he was also a friend and confidante of former President, Richard Nixon. And recently released Nixon White House tapes provide us an example of how utterly bizarre Linkletter and Nixon were.

In what other nation could an orphan abandoned in Moose Jaw, Saskatchewan rise to become the intimate confidante of the vicious, paranoid Dilantin-addicted Presdient?

I guess it's public health night

Kewl abstinence education. (For fairness and balance vs. the baby stuff.)

Sex is for

UN Dispatch

FYI, UN Dispatch is a new blog administered by Peter Daou and sponsored by the United Nations Foundation.

Daou writes:

In the many hours I spend surveying blogs and online forums to prepare the Daou Report it's clear to me that there's a very narrow range of UN-related content on blogs, virtually all of it associated with controversies such as Oil-for-Food. There's little discussion of the wide range of humanitarian work performed by UN bodies, everything from measles initiatives to Tsunami relief to global environmental issues to women's rights.

Helping children in need, working for a healthier environment, leading disaster relief efforts around the globe, these are not partisan issues, and I believe that stepping up to defend the UN's works in these areas is the right thing to do. I'm aware that UN Dispatch will be the target of criticism by opponents of the UN. I welcome a vigorous debate, and invite everyone on this list to be part of the discussion.

Amongst other things, UNdispatch is blogging the World Health Organization's Great Expectations program:

"In the lead up to World Health Day on 7 April this year, six mothers living in different countries of the world are sharing their experiences of pregnancy and childbirth. In this fourth part of Great expectations, the babies are one week old. They have reached a significant milestone in their lives, as the risk of death in the first seven days is higher than at any point in the first five years of a child's life."

The theme of World Health Day 2005 is maternal and child health. As part of the run-up to the event, the World Health Organization is following six mothers from their 5th month of pregnancy through the 6th month of their new babies' lives.

The international baby cohort has recently completed its first week on the planet. [Ed: Much cuter than reality TV.]

Happy first Friday, little guys.

Blog triumphalism revisited

Via James Wolcott, I learn that Jeff Jarvis has issued an APB regarding His Holiness:

Help! Papal blog posts needed!

: MSNBC just changed the show to do a full hour on the pope and I need any blog posts or sites about this. Please, please give me comments here.

: Watching MSNBC now I saw Dr. Joyce Brothers actually break down about it. Strange moment of TV.

To which a commenter replies:

VodkaPundit had a quick comment about it here. I don't know what kind of role the blogosphere plays or even can play in something like this. It seems to me that even if he were to pass away, the nature of the Conclave would prevent any information other than pure speculation to be traded.

Posted by [GD] at February 24, 2005 03:57 PM

C'mon. Surely the there's a blogging Cardinal out there. It's time the Cards did something useful.

My guess is that if anyone's got the straight steamin' hot papal bull, it's Fafnir.

Caveat medicus

UCLA Study Shows One-Third Of Drug Ads In Medical Journals Do Not Contain References Supporting Medical Claims

UCLA investigators reviewed pharmaceutical ads in American medical journals and found that nearly one-third contained no references for medical claims; while the majority of references to published material was available, only a minority of company data-on-file documents were provided upon request; and the majority of original research cited in the ads was funded by or had authors affiliated with the product's manufacturer. [Science Daily]

Here is the original paper:

Cooper RJ, Schriger DL. The availability of references and the sponsorship of original research cited in pharmaceutical advertisements. CMAJ. 2005;72: February 15. [Free full-text]

I can say that the Cooper and Schriger results are fully consistent with my experience as a medical writer.

The Science Daily article emphasizes that nearly one third (29%) of journal ads in major American medical journals made medical claims without supporting evidence. Actually, this is a relatively minor point in the original article. Moreover, this fact doesn't mean much unless you know what the authors count as a medical claim, what the law considers to be a medical claim, and how the unreferenced ads stacked up against each standard. Some statements are so vacuously promotional that they require no specific reference.

The key finding of this study is the heavy reliance on company-funded research and proprietary "data on file" to support promotional claims. Cooper and Schriger report that 58% of ads indicated that they were citing industry-funded research and that 23% didn't say who funded the research cited. 54% of the pharmaceutical ads referenced at least one claim to "data on file."

When the investigators submitted written requests for this "data on file" to the pharmaceutical companies, they were only able to obtain the information 20% of the time, despite repeated attempts. The companies only responded to 42% of the researchers' letters, and 51% of these responses were refusals to provide "proprietary" information.

I know that if I were a physician, I would discount any claim referenced as "data on file" in a pharmaceutical ad or a continuing medical education resource. These "files" are epistemological sewers. Sewers sometimes contain interesting things like alligators and hot maintenance workers -- but that doesn't mean you should buy things dredged out of the sewer sight unseen.

"Data on file" can be anything: last year's promotional brochure, an internal research monograph, a company doc's unpublished remarks at a closed-door advisory board meeting, or an old PowerPoint slide proffered by a marketing bigshot or a key opinion leader. (To be fair, last year's brochure would only be cited as DOF if contained a key reference couldn't be secured in time. In a pinch, you can cite the brochure itself -- cause, hey, it passed review last time!)

As a rule, medical writers resort to citing data on file when they can't find a journal article to support the claim that they've been told to back up. The internal medical and legal reviewers don't like to cite DOF either. Frankly, it looks sketchy and it invites awkward questions from lawyers and regulators.

Cooper and Schriger wanted to know whether supporting materials would be available to a conscientious physician who wanted to check the primary sources. As they note, there is already a substantial and rather depressing literature on the quality of references in pharmaceutical ads. I won't review it here, but interested readers can consult the references section of Cooper and Schriger's paper.

I would add that retrospective audits overestimate the epistemological quality of many promotional materials, because claims often drive the citations, rather than the other way around. The standard audit methodology is very straightforward -- medical experts read the claim and the reference, and judge how well the latter supports the former. This type of research can't detect the cases in which the reference was created expressly to advance a non-scientifically motivated claim.

Every ad begins with a creative brief that lists the brand messages that the ad must convey. Sometimes the brief will specify which studies should be used to substantiate key claims. However, it's usually up to the copywriter or medical writer at the ad agency to find support in the literature for these ideas after the company's marketing team has already decided what story to tell. Of course, the medical team works with the marketing people to reign in creative excess. But the medical team isn't just passively fact-checking -- they are also scanning the literature for marketing angles and crafting messages for maximum appeal to medical professionals.

Henry Ford demanded strict vertical integration in automobile manufacturing. He wanted to control every step in the process from mining ore and farming rubber to affixing the fenders to a Model T. Big pharma takes the same approach to the production and distribution of scientific information. Often experimental hypotheses are framed by marketing executives before a potential investigator has been retained. The company identifies influential doctors, sponsors their research, pays in-house writers to draft the manuscript, and shops the papers to journals. Once a claim appears in a journal it can be milked indefinitely, backed by the full faith and credit of science.

There's an entire field called "publication planning", which is, sickeningly, a lucrative sideline for many journal publishers. If I were a physician, I would would maintain a very high index of suspicion towards any article published as a supplement to a journal or as part of a special theme issue.

Review articles are sometimes drafted before the ostensible author knows he might be offered an honorarium to sign his or her name (after due consultation and with input, if desired). When rival studies go to press, PR firms draft letters to journal editors to be signed by opinion leaders.

Pharmaceutical companies often host concurrent symposia during major medical conferences at which their key opinion leaders give presentations, supported by slick slide decks and handouts. These symposia are written up in monographs and published in journals. These talks are also fodder for continuing medical education (CME) activities. By law, physicians must earn a certain number of CME credits in order to renew their licenses (typically 100 hours of credit per 2-year licensing period). You'll be glad to know that pharmaceutical companies generously supply doctors with all the CME they could ever need.

Clinical guidelines are another opportunity for big pharma to influence medical practice while generating new grist for the promotional mill. Many of their key opinion leaders serve on the boards of medical societies and on advisory committees that draft clinical guidelines. These guidelines are published in reputable journals and plowed back into yet more CME modules.

I once read that all of LA's drinking water had already been routed through the water and sewer system six times. I'm not sure if that's accurate, but the metaphor applies to many of the medical memes that appear in journal articles and journal ads. Constant recycling doesn't necessarily taint drinking water. In fact, you're much better off drinking the water from the tap than you would be collecting rainwater or drinking from random puddles and streams. Likewise, the products of the medical communications industry aren't necessarily bogus just because of their obscure and dubious origins. Still, like Angelinos, consumers of medical information should appreciate the value of a personal filtration system.

Thanks to Revere of Effect Measure for the tip.

February 23, 2005

I can rent penguins?

I love penguins. I was so excited when I heard that Southwest Airlines does penguin flights. Apparently, Southwest even lets passengers play with the penguins, although this might be a privilege reserved for clergy.

Unfortunately, they only fly to Seaworld. I wish they would do penguin flights from New York to Vancouver. [Edit: A reader informs me that Southwest is no longer doing penguin tours.]

Luckily, according to this link from alicublog, I can rent my own goddamned penguins, just like P Diddy:

The animal rights zealots are apoplectic that six petrified-looking penguins were placed on a floating plexiglass platform in the pool at the opening of the Hotel Victor last Friday night. Several partygoers told PAGE SIX that the cold-weather birds were huddled in the corner of their platform the whole night, fearful of slipping down a slide into the pool's balmy waters." [NY Post]

It sounds like P Diddy was kind of a jerk to the penguins. Probably he thinks that just because penguin is rented it's an excuse not to treat it right. I promise that I'll be much more sensitive to my rental penguins' needs. I'll fill the bathtub with plenty of party ice and buy extra herring for shooters.

Koufax Awards announced

The winners of the 2004 Koufax Awards have been announced.

Thanks to everyone who turned out to support Majikthise in the nominations, the semi-finals, and the finals. Y'all voted early and voted often. Your support means a lot.

Thanks also to Dwight, Mary Beth, and Eric of Wampum for hosting the Koufax Awards. The Wampum crew is doing great work for the liberal blogosphere while ensuring that a good time is had by all.

Congratulations to this year's winner of Blog Most Deserving of Wider Recognition: Susan of Suburban Guerrilla. I'm delighted to report that Dohiymir and Majikthise came away with honorable mentions. It was an exciting race against an exceptionally strong field.

So, what are you waiting for? Go check out the rest of the results for Koufax 2004!

The case against Summers

Ideologues are spreading misinformation about Larry Summers' dim future at Harvard. They are trying to paint him as a martyr to academic freedom, a visionary leader who fell on his sword to "stimulate open debate." In fact, Summers' controversial remarks to the National Bureau of Economic Research (NBER) are merely symptomatic of his shortcomings as president.

Elizabeth Anderson has an excellent post about Summers in which she presents evidence that he is no friend of open debate. She argues that it is precisely Summers' arrogant and heavy-handed approach that has alienated his own faculty. Summers has a history of grandstanding and capricious interference. Summers' dealings with Cornel West are a case in point. Anderson writes:

President Summers berates Cornel West for grade inflation, supposedly declining scholarship,  and supporting Al Sharpton's campaign for President.  Professor West leaves in a huff for Princeton.  What's wrong with this?  Comments like this one on the substantive merits of Summers' opinion of West miss the point. Grade inflation is a serious issue well within the province of the President.  But it is ludicrous and demeaning to single out West on this count, given its pervasiveness at Harvard.  Systematic problems demand systematic and impersonal solutions, not arbitrary Presidential second-guessing of the grading patterns of individual faculty whom he holds in contempt.  The same point applies to concerns about scholarly productivity of tenured faculty members.  What may be a legitimate form of institutional accountability and standard-setting in an impersonal, publicly vetted, and universally applied system of rules becomes an imperious violation of academic freedom in the hands of a President who applies privately tailored standards at his personal discretion.  As for West's extra-curricular political activities, these are none of the President's business.  My concern is not only with contract feudalism.  It's with political correctness.  Those who hailed Summers for taking down West, a supposed practitioner of political correctness, should have excoriated Summers instead, for presuming to dictate to faculty what political affiliations are correct for a Harvard professor to have. [Emphasis added.]

Feverish defenses of Summers' academic freedom are utterly beside the point. If Summers is fired, it will be for being a bad president, not for shooting off his mouth to the NBER. Summers is first and foremost an administrator. Tact and diplomacy are essential for a university president. He or she is responsible for maintaining positive public relations, especially with potential donors and prospective faculty members.

Professors are paid to provoke but administrators are paid to make nice.

As far as Summers' future at Harvard is concerned, his remarks to the NBER should be faulted first and foremost for being unprofessional. Summers is an elite administrator who gets paid big bucks to display sound judgment, foresight, and discretion. Professionals prioritize competing goods--e.g., the satisfaction of intellectual provocation vs. the imperatives of a senior administrative position. It reflects poorly on Summers that he couldn't resist the temptation to expound on his pet theories regardless of the easily foreseeable consequences.

If Summers gets the axe it will be for operating like a bull in a china shop for three years. Anyone who claims he's a victim of political correctness is either ill-informed or disingenuous.

Right wing paramilitary organizations

'Minutemen' plan to patrol Arizona border

WASHINGTON (AP) -- Intent on securing the vulnerable Arizona border from illegal immigrant crossings, U.S. officials are bracing for what they call a potential new threat this spring: the Minutemen.

Nearly 500 volunteers have already joined the Minuteman Project, anointing themselves civilian border patrol agents. They plan to patrol a 40-mile stretch of the southeast Arizona border throughout April when the tide of immigrants crossing the U.S.-Mexico border peaks.

"I felt the only way to get something done was to do it yourself," said Jim Gilchrist, a retired accountant and decorated Vietnam War veteran who is helping recruit Minutemen across the country.

Across the country? How many vigilantes does Arizona need?

Officials fear the Minuteman patrols could cause more trouble than they prevent. At least some of the volunteers plan to arm themselves during the 24-hour desert patrols. Many are untrained and have little or no experience in confronting illegal border crossings.

"Any time there are firearms and you're out in the middle of no-man's land in difficult terrain, it's a dangerous setting," said Bonner, whose agency is keeping a close eye on the Minutemen plans.

From an HR perspective it's probably wise to broaden the recruiting base. As Steve Gilliard notes the Minuteman project will need to offset a relatively high attrition rate:

Atrios is concerned that these folks will bring back the bad old days, when whites killed Mexicans for sport, sort of like game hunting.

I'm more concerned that these halfwits will either shoot themeselves or get killed by the drug dealers and coyotes, Like all good dick swinging white men, they think all they need is a gun and white skin to control the border. Well, Mexicsns have their own cowboy myths and a lot more experience at gunplay. So the odds are that these simpletons, when not running into DEA operations, may well stumble on people who would kill them like a deer for dinner.

The odds are a LOT higher that a few of these folks will turn up dead than they will kill immigrants.

[Via Dr. Pretorius.]

February 22, 2005

Women bloggers

Here we go again...

"Where are the A-list female bloggers?"

Inside this inane question are some sensible questions trying to get out. Unfortunately, this question is rarely asked by anyone who is genuinely curious. For the most part, "the women blogger thing" is a convenient pretext to expound upon the Differences between males and females. Some bloggers broach the topic as an oblique way to denigrate women in general: Why aren't there more female bloggers? Because, women are generally less political, less intelligent, and less motivated--so we shouldn't expect much from that group.

A: Where are so few of the A-list political blogs written by women? Aren't women interested in politics?

B: Many popular female bloggers write about politics, but their contributions are often overlooked or miscategorized as apolitical if they work in a more personal or narrative format.

A: Okay. I'm just wondering why there aren't more women in the high traffic, news-oriented, heavily hyperlinked blogs. You know, like Atrios, Kos, or Instapundit? Is Wonkette the only XX A-lister? If these narrative bloggers are so great why aren't they showing up more in the TTLB ecosystem, or on other measures of blog influence? (I bet it's ev psych!)

B: We could argue about whether our society irrationally discounts stereotypically feminine modes of expression, how to define the A-list, what percentage of female bloggers aspire to be on somebody's A-list, or whatever. We could speculate about how much of the variance in site traffic can be explained by sexism vs. social conditioning vs. sun spots vs. having a nice picture. The fact remains nobody ever offers any data to substantiate these hypotheses.

Instead, let me recommend some female bloggers doing top-notch work in the mainstream poliblog format. Far from being marginalized or underrated, these blogs are key players in the blogosphere. Most have already been cited and/or blogrolled by A-listers and some are on the "speed dial." Several of these women have earned mainstream media appearances on the strength of their blogs. Many are award winners. One was a credentialed DNC blogger.

Elizabeth Anderson of Left2Right
Jessica Wilson of For the Record
Julie Saltman
Respectful of Otters
Body and Soul
Jeralyn Merritt of TalkLeft
Hilzoy of Obsidian Wings
Julia of Sisyphus Shrugged
Jane Galt of Asymmetrical Information
Laura Rozen of War and Piece
DC Media Girl
Maia Cowen of Failure is Impossible.

Here are some influential female bloggers who provide excellent political commentary in slightly less "traditional" formats:

Belle Waring
Rox Populi
HE Baber
Teresa Nielsen Hayden
Bitch PhD

(This is an abbreviated and eclectic sampling. I hope readers will add their favorites to the comments.)